脂蛋白磷脂酶A2和髓过氧化物酶与超敏C反应蛋白及全球急性冠状动脉事件注册评分的相关性

摘要

目的 探讨不同类型冠心病患者外周血脂蛋白磷脂酶A2和髓过氧化物酶水平的变化,及与超敏C反应蛋白和全球急性冠状动脉事件注册评分的相关性.方法 选择行冠状动脉造影术的住院患者150例,其中无症状心肌缺血(SMI)组28例,稳定型心绞痛(SAP)组59例,急性冠脉综合征(ACS)组63例,采用酶联免疫吸附试验(ELISA法)测定血清脂蛋白磷脂酶A2、髓过氧化物酶水平,乳胶免疫比浊法测定超敏C反应蛋白水平,并计算患者全球急性冠状动脉事件注册评分,分析脂蛋白磷脂酶A2和髓过氧化物酶与超敏C反应蛋白、全球急性冠状动脉事件注册评分危险分层的关系.结果 急性冠脉综合征组外周血血清脂蛋白磷脂酶A2、髓过氧化物酶和超敏C反应蛋白均高于稳定型心绞痛组和无症状心肌缺血组,差异有统计学意义(P<0.05);稳定型心绞痛组外周血血清脂蛋白磷脂酶A2、髓过氧化物酶和超敏C反应蛋白水平与无症状心肌缺血组比较,差异均无统计学意义(P>0.05);血清脂蛋白磷脂酶A2与髓过氧化物酶、超敏C反应蛋白均呈正相关(r=0.793,P<0.05;r=0.769,P<0.05),髓过氧化物酶水平与超敏C反应蛋白也呈正相关(r=0.743,P<0.05);而血清脂蛋白磷脂酶A2、髓过氧化物酶和超敏C反应蛋白水平与患者全球急性冠状动脉事件注册评分均无相关性.结论 联合检测血清脂蛋白磷脂酶A2、髓过氧化物酶和超敏C反应蛋白水平或联合全球急性冠状动脉事件注册评分可能有助于进一步有效评估冠心病危险分层,对冠心病的及时干预和治疗可能有重要意义.%Objective To investigate the correlations among Lp -PLA2, MPO, C-reactive protein (Hs-CRP) and global registry of acute coronary events risk score ( GRACE) risk score in patients with CHD .Methods A hundred and fifty patients were divided into 3 groups undergoing the coronary angiography , stable myocardial infarction ( SMI ) group (n=28), stable angina pectoris (SAP) group (n=59), and ACS group (n=63).The serum levels of Lp -PLA2 and MPO were detected by enzyme -linked immunosorbent assay (ELISA), the serum level of Hs-CRP was detected by latex immunoturbidimetry , and GRACE risk scores were recorded .The correlations among Lp -PLA2, MPO, Hs-CRP and GRACE risk score were analyzed .Results The serum levels of Lp -PLA2, MPO and Hs-CRP in ACS group were significantly higher than SAP group and SMI group (P<0.05), while there was no significant difference in serum Lp -PLA2, MPO or Hs-CRP between SAP group and SMI group (P>0.05).Lp-PLA2 was significantly correlated with MPO and Hs-CRP in CHD groups (r=0.793, P<0.05; r=0.769, P<0.05); meanwhile, MPO was significantly correlated with Hs-CRP in CHD groups ( r=0.743, P<0.05).There was no significant correlation between Lp -PLA2, MPO or Hs-CRP and GRACE risk score in CHD groups .Conclusion It can further help to assessment the strat-ification of CHD risk and can be more beneficial to predicting and treating the coronary artery disease by jointing test the serum levels of Lp-PLA2, MPO and Hs-CRP or using GRACE risk scores.